Страна: САЩ
Език: английски
Източник: NLM (National Library of Medicine)
DIMETHYL FUMARATE (UNII: FO2303MNI2) (MONOMETHYL FUMARATE - UNII:45IUB1PX8R)
Ascend Laboratories, LLC
ORAL
PRESCRIPTION DRUG
Dimethyl fumarate delayed-release capsules is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Dimethyl fumarate delayed-release capsules is contraindicated in patients with known hypersensitivity to dimethyl fumarate or to any of the excipients of dimethyl fumarate delayed-release capsules. Reactions have included anaphylaxis and angioedema [see Warnings and Precautions (5.1)]. Risk Summary There are no adequate data on the developmental risk associated with the use of dimethyl fumarate delayed-release capsules in pregnant women. In animals, adverse effects on offspring survival, growth, sexual maturation, and neurobehavioral function were observed when dimethyl fumarate (DMF) was administered during pregnancy and lactation at clinically relevant doses [see Data]. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. The background risk of major birth defects and miscarriage for the indicated population is unknown. Data Animal Data In rats administered DMF orally (25, 100, 250 mg/kg/day) throughout organogenesis, embryofetal toxicity (reduced fetal body weight and delayed ossification) were observed at the highest dose tested. This dose also produced evidence of maternal toxicity (reduced body weight). Plasma exposure (AUC) for monomethyl fumarate (MMF), the major circulating metabolite, at the no-effect dose is approximately three times that in humans at the recommended human dose (RHD) of 480 mg/day. In rabbits administered DMF orally (25, 75, and 150 mg/kg/day) throughout organogenesis, embryolethality and decreased maternal body weight were observed at the highest dose tested. The plasma AUC for MMF at the no-effect dose is approximately 5 times that in humans at the RHD. Oral administration of DMF (25, 100, and 250 mg/kg/day) to rats throughout organogenesis and lactation resulted in increased lethality, persistent reductions in body weight, delayed sexual maturation (male and female pups), and reduced testicular weight at the highest dose tested. Neurobehavioral impairment was observed at all doses. A no-effect dose for developmental toxicity was not identified. The lowest dose tested was associated with plasma AUC for MMF lower than that in humans at the RHD. Risk Summary There are no data on the presence of DMF or MMF in human milk. The effects on the breastfed infant and on milk production are unknown. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for dimethyl fumarate delayed-release capsules and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition. Safety and effectiveness in pediatric patients have not been established. Clinical studies of dimethyl fumarate delayed-release capsules did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients.
Dimethyl fumarate delayed-release capsules is available as hard gelatin delayed-release capsules in two strengths containing either 120 mg or 240 mg of dimethyl fumarate. The 120 mg capsules have an opaque green cap printed with "DMF" and opaque white body printed with" 120" in black ink. The 240 mg capsules have an opaque green cap printed with "DMF" and opaque green body printed with "240" in black ink. Dimethyl fumarate delayed-release capsules is available as follows: 30-day Starter Pack, (67877-557-39): 7-day bottle 120 mg capsules, quantity 14 23-day bottle 240 mg capsules, quantity 46 120 mg capsules: Bottle Pack of 14 capsules (67877-555-14) Bottle Pack of 90 capsules (67877-555-90) Bottle Pack of 1000 capsules (67877-555-10) Blister Pack of 10 capsules (67877-555-33) 240 mg capsules: Bottle Pack of 46 capsules (67877-556-46) Bottle Pack of 60 capsules (67877-556-60) Bottle Pack of 90 capsules (67877-556-90) Bottle Pack of 1000 capsules (67877-556-10) Blister Pack of 10 capsules (67877-556-33) Store at 15°C to 30°C (59 to 86°F). Protect the capsules from light. Store in original container.
Abbreviated New Drug Application
DIMETHYL FUMARATE - DIMETHYL FUMARATE CAPSULE, DELAYED RELEASE DIMETHYL FUMARATE- DIMETHYL FUMARATE ASCEND LABORATORIES, LLC ---------- HIGHLIGHTS OF PRESCRIBING INFORMATION THESE HIGHLIGHTS DO NOT INCLUDE ALL THE INFORMATION NEEDED TO USE DIMETHYL FUMARATE DELAYED-RELEASE CAPSULES SAFELY AND EFFECTIVELY. SEE FULL PRESCRIBING INFORMATION FOR DIMETHYL FUMARATE DELAYED-RELEASE CAPSULES. DIMETHYL FUMARATE DELAYED-RELEASE CAPSULES, FOR ORAL USE INITIAL U.S. APPROVAL: 2013 RECENT MAJOR CHANGES Warnings and Precautions,Lymphopenia (5.4) 02/2023 INDICATIONS AND USAGE Dimethyl fumarate delayed-release capsules is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. (1) DOSAGE AND ADMINISTRATION Starting dose: 120 mg twice a day, orally, for 7 days (2.1) Maintenance dose after 7 days: 240 mg twice a day, orally (2.1) Swallow dimethyl fumarate delayed-release capsules whole and intact. Do not crush, chew, or sprinkle capsule contents on food (2.1) Take dimethyl fumarate delayed-release capsules with or without food (2.1) DOSAGE FORMS AND STRENGTHS Delayed-release capsules: 120 mg and 240 mg (3) CONTRAINDICATIONS Known hypersensitivity to dimethyl fumarate or any of the excipients of dimethyl fumarate delayed-release capsules. (4) WARNINGS AND PRECAUTIONS Anaphylaxis and angioedema: Discontinue and do not restart dimethyl fumarate delayed-release capsules if these occur. (5.1) Progressive multifocal leukoencephalopathy (PML): Withhold dimethyl fumarate delayed-release capsules at the first sign or symptom suggestive of PML. (5.2) Herpes zoster and other serious opportunistic infections: Consider withholding dimethyl fumarate delayed-release capsules in cases of serious infection until the infection has resolved. (5.3) Lymphopenia: Obtain a CBC including lymphocyte count before initiating dimethyl fumarate delayed- release capsules, after 6 months, and every 6 to 12 months thereafte Прочетете целия документ